Active NPI
Morgan County Health Center
- Public Health or Welfare Agency
- Versailles, MO
National Provider Identifier
1447456330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health or Welfare Agency
- Legal business name
- MORGAN COUNTY HEALTH CENTER
- Practice address
- 104 W Lafayette St
Versailles, MO 65084-1346 - Phone
- (573) 378-5438
- Fax
- (573) 378-2726
- NPI assigned
- Jun 26, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shawn Brantley
- Title
- Assistant Administrator
- Phone
- (573) 378-5438
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | Primary |
Addresses
Primary practice location
104 W Lafayette St
Versailles, MO 65084-1346
Mailing address
104 W Lafayette St
Versailles, MO 65084-1346
Phone (573) 378-5438
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131125000705 | MO | Part B Supplier - Mass Immunization (Roster Biller Only) | 2466688353 | Practice locations: Versailles, MO |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D0666752 | Morgan County Health Center | Certificate of waiver | Mar 12, 2027 |
National Provider Directory
National Provider DirectoryLocations
104 W Lafayette St
Versailles, MO 65084
Phone (573) 378-5438
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Registered Nurse
- Versailles, MO
- NPI 1558117630
-
- Licensed Practical Nurse
- Versailles, MO
- NPI 1326691288
-
- Lactation Consultant (Registered Nurse)
- Versailles, MO
- NPI 1235797622
-
- Licensed Practical Nurse
- Versailles, MO
- NPI 1972156735
-
- Health Educator
- Versailles, MO
- NPI 1831070119
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182816000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1447456330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 W LAFAYETTE ST",
"city": "VERSAILLES",
"state": "MO",
"postal_code": "650841346",
"telephone_number": "573-378-5438",
"fax_number": "573-378-2726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 W LAFAYETTE ST",
"city": "VERSAILLES",
"state": "MO",
"postal_code": "650841346",
"telephone_number": "573-378-5438",
"fax_number": "573-378-2726"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MORGAN COUNTY HEALTH CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2007-06-26",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "BRANTLEY",
"authorized_official_first_name": "SHAWN",
"authorized_official_title_or_position": "ASSISTANT ADMINISTRATOR",
"authorized_official_telephone_number": "573-378-5438"
},
"taxonomies": [
{
"code": "251K00000X",
"taxonomy_group": "",
"desc": "Public Health or Welfare",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Versailles, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.